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Aim <p>Influenza poses a substantial health burden in children. The incidence of influenza dropped sharply during the COVID-19 pandemic, but it is uncertain whether this shift influenced clinical outcomes among hospitalised children. This study aimed to compare the epidemiology and clinical outcomes of paediatric influenza before and after the pandemic.</p> Method <p>We conducted a retrospective cohort study of children ≤ 17 years who were admitted to the Sydney Children’s Hospitals Network (SCHN) with laboratory-confirmed influenza between January 2015 and December 2023. Data were extracted from medical records at SCHN. Differences in clinical outcomes across pre-COVID (2015–2019), during COVID-19 (2020–2021) and post-COVID (2022–2023) periods were described descriptively, while inferential analysis comparing clinical outcomes were restricted to the pre- and post-COVID periods using generalised estimating equations (GEE).</p> Results <p>A total of 2,490 children with influenza were included in this study (857 pre-COVID, 49 during COVID-19 and 1,584 post-COVID). Compared with pre-COVID, influenza seasons in the post-COVID (2022–2023) began earlier (March vs. April) and peaked earlier (June vs. August), and affected older children (median age 5 [IQR 2–8] vs. 3 [IQR1-7] years). During post-COVID period, adjusted mean hospital length of stay was 32% shorter than in the pre-COVID period (MR, 0.68; 95% CI, 0.59–0.78). Lower odds of ICU admission were observed overall, although sensitivity analyses suggested this finding was not consistent across comorbidity strata.</p> Conclusion <p>We observed differences in the characteristics and clinical outcomes of children hospitalised with influenza across the pre-, during and post-COVID periods. Changes in seasonality and age distribution were also observed in the post-COVID period. These findings highlight changes in hospital burden over time and importance of continued surveillance and flexible healthcare and vaccination planning to accommodate evolving influenza epidemiology.</p>

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Epidemiology and clinical outcomes of influenza in hospitalised children ≤ 17 years before and after COVID-19 pandemic in a tertiary paediatric network in Sydney, Australia

  • 期刊论文

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  • 发表日期：

    2026年7月14日

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  • Sadaf Orya,
  • Jahidur Rahman Khan,
  • Bernadette Prentice,
  • Louisa Owens,
  • Philip Britton,
  • Adam Jaffe,
  • Nusrat Homaira,
  • Mei Chan

摘要

Aim

Influenza poses a substantial health burden in children. The incidence of influenza dropped sharply during the COVID-19 pandemic, but it is uncertain whether this shift influenced clinical outcomes among hospitalised children. This study aimed to compare the epidemiology and clinical outcomes of paediatric influenza before and after the pandemic.

Method

We conducted a retrospective cohort study of children ≤ 17 years who were admitted to the Sydney Children’s Hospitals Network (SCHN) with laboratory-confirmed influenza between January 2015 and December 2023. Data were extracted from medical records at SCHN. Differences in clinical outcomes across pre-COVID (2015–2019), during COVID-19 (2020–2021) and post-COVID (2022–2023) periods were described descriptively, while inferential analysis comparing clinical outcomes were restricted to the pre- and post-COVID periods using generalised estimating equations (GEE).

Results

A total of 2,490 children with influenza were included in this study (857 pre-COVID, 49 during COVID-19 and 1,584 post-COVID). Compared with pre-COVID, influenza seasons in the post-COVID (2022–2023) began earlier (March vs. April) and peaked earlier (June vs. August), and affected older children (median age 5 [IQR 2–8] vs. 3 [IQR1-7] years). During post-COVID period, adjusted mean hospital length of stay was 32% shorter than in the pre-COVID period (MR, 0.68; 95% CI, 0.59–0.78). Lower odds of ICU admission were observed overall, although sensitivity analyses suggested this finding was not consistent across comorbidity strata.

Conclusion

We observed differences in the characteristics and clinical outcomes of children hospitalised with influenza across the pre-, during and post-COVID periods. Changes in seasonality and age distribution were also observed in the post-COVID period. These findings highlight changes in hospital burden over time and importance of continued surveillance and flexible healthcare and vaccination planning to accommodate evolving influenza epidemiology.